III: Neonates Flashcards
_____ apnea: requires PEEP to stablish lung inflation and begin regular respirations
secondary
_____ apnea: stimulation easily initiates a cry
primary
Absorption of lung fluid around birth involves _____ channels that may be stimulated by _______.
ENaC; cortisol
After birth, ______ alveolar oxygen _____ pulmonary vascular resistance and _____ pulmonary blood flow.
increased; decreases; increases
Cord clamping increases _______, which increases ______ in the aorta.
SVR, pressure
Define the normal blood pressure for a neonate.
60-90/30-60
Define the normal repiratory rate for a neonate.
40-60/minute
Describe the CXR in the context of surfactant deficiency.
Ground glass or whiteout appearance
During labor, ______ increases to move fluid out of the lungs
Transpulmonary pressure
Fetal pulmonary epithelium actively secretes _____ ions.
chloride
In calcium homeostasis, neonate ___ levels increase and peak at 48 hours, while ____ levels increase immediately after birth and then fall
PTH; calcitonin
Name the 5 parameters measured in Apgar scores.
HR, respirations, tone, response to suction, color
Name the Apgar criteria for color.
0/pale, 1/acrocyanosis, 2/completely pink
Name the Apgar criteria for HR.
0/absent, 1/HR below 100, 2/HR above 100
Name the Apgar criteria for respirations.
0/absent, 1/irregular or gasping, 2/regular and crying
Name the Apgar criteria for response to suction.
0/none, 1/grimace, 2/cough/sneeze/cry
Name the Apgar criteria for tone.
0/limp, 1/some flexion, 2/active motion
Name the normal heart rate for a neonate at 1 hour after birth.
120-140
Name the three types of pulmonary hypertension in order of decreasing reversibility.
Constricted pulmonary vessels, abnormal pulmonary vascular musculature, Hypoplastic pulmonary vasculature
Umbilical vein shunting to the IVC occurs via the _______.
Ductus venosus
What is a distinct method by which neonates protect against hypothermia?
Non-shivering thermogenesis (brown fat)
What is the diagnosis? Jitteriness and seizures 24-48 horus after birth
Hypocalcemia
What is the diagnosis? Jitteriness, lethargy, irritability, apnea, seizures
Neonatal hypoglycemia
What is the effect on pulmonary vasculature? Acidosis
constriction
What is the effect on pulmonary vasculature? Alveolar expansion
dilation
What is the effect on pulmonary vasculature? Endothelin
constriction
What is the effect on pulmonary vasculature? Leukotrienes
constriction
What is the effect on pulmonary vasculature? NO
dilation
What is the effect on pulmonary vasculature? Oxygen
dilation
What is the effect on pulmonary vasculature? Prostacyclin
dilation
What is the most common cause of oligohydramnios causing pulmonary hypoplasia?
Premature membrane rupture
What is the physiologic limit of fetal lung maturity?
22-24 weeks gestation
Which diagnosis? Differential oxygen saturation of right arm and other extremities
Ductus arteriosus shunt
Which diagnosis? Failure of fluid absorption leading to retained fetal lung fluid
Transient Tachypnea of the Newborn
Which diagnosis? High pulmonary vascular resistance following birth that may result in persistent right to left shunts
Persistent Pulmonary Hypertension of the Newborn
